Glucocorticoids

Glucocorticoids — a group of synthetic drugs similar to cortisol, a hormone produced by the adrenal cortex. They have pronounced anti-inflammatory and immunosuppressive effects and are used for a wide range of diseases.

The effectiveness of the drugs is combined with a systemic impact on metabolism, which requires monitoring during prolonged use.

Mechanism of Action

Glucocorticoids bind to intracellular receptors and regulate the expression of genes responsible for the inflammatory response.

Key effects include:

• reduction of pro-inflammatory cytokine synthesis;
• decreased vascular permeability;
• suppression of immune cell activity;
• inhibition of allergic reactions.

Metabolic effects:

• increased gluconeogenesis in the liver;
• reduced tissue sensitivity to insulin;
• accelerated protein breakdown;
• redistribution of adipose tissue;
• sodium and water retention.

Forms and Methods of Administration

• systemic forms — tablets and injections, used for severe inflammatory and autoimmune conditions;
• local forms — creams, ointments, inhalers, nasal sprays, and eye drops;
• prolonged injections — used for chronic diseases to maintain long-term symptom control.

Indications:

• autoimmune diseases;
• allergic reactions;
• asthma;
• inflammatory skin diseases;
• rheumatological pathologies;
• edematous and inflammatory conditions of various origins.

Side Effects and Risks

The risk depends on dosage and duration of therapy:

• hyperglycemia;
• increased blood pressure;
• fluid retention and edema;
• decreased muscle mass;
• osteoporosis;
• sleep and mood disturbances;
• increased appetite and changes in fat distribution.

Impact on Metabolism and Ketogenic Diet

Glucocorticoids can raise blood glucose levels due to stimulation of gluconeogenesis and decreased insulin sensitivity. This can temporarily hinder the maintenance of ketosis:

• possible increase in glycemia even with low carbohydrate intake;
• appetite may increase;
• tendency for fluid retention may be observed;
• long-term use may lead to loss of muscle mass.

With short-term use, pronounced changes are usually reversible.